Friday, Jan. 9, 2004 | 11 a.m.
A Las Vegas doctor is being sued for allegedly fostering drug addictions among her patients by prescribing excessive amounts of pain pills and selling the narcotics out of her Las Vegas-area clinic.
A lawsuit filed Dec. 18 by attorney Marc Saggese claims Dr. Pamela Gabriel prescribed thousands of highly addictive pain pills such as Hydrocodone, Oxycontin, Oxycodone, Lortab and Lorcet to dozens of patients under her care, often without examining them.
Although the suit was filed on behalf of patient Jonathan Woody, nearly a dozen other patients have come forward in recent weeks with identical allegations, Saggese said.
Saggese claims the doctor sold the narcotics out of her Las Vegas clinic "at rock-bottom prices," often without a proper written prescription.
The former patients claim Gabriel sold the medication for about $30 for a bottle of 90 pills. The average price of the medication would generally run about $90 a bottle, he said.
"No examination, no X-rays, no MRI, just 'What's wrong and how many do you want?' " Saggese said.
A secretary reached Thursday at Gabriel's office said the doctor did not wish to comment on the lawsuit. Calls were referred to Gabriel's attorney, Michelle Schwarz. Schwarz did not return repeated calls for comment.
The Nevada Board of Medical Examiners issued Gabriel's medical license on June 6, 2000. The board would not comment on whether Gabriel had an investigation pending, citing privacy concerns.
According to the Board of Medical Examiners, Gabriel is a pediatrician with a sub-discipline of preventive medicine. Her license is valid through June 30, 2005.
Dr. Don Frisch, doctor of pharmacy and clinical specialist at University Medical Center, said narcotics such as Oxycontin are considered controlled substances by the federal government.
Federal law requires that the medications be given out only with a valid prescription, he said. If a doctor is giving patients the medication from a clinic supply, "that is illegal," Frisch said.
"You can't get samples of controlled substances," he said. "And if a physician is prescribing these drugs without a valid diagnosis, that is unethical."
At pharmacies controlled substances, often called scheduled medications, are more regulated than regular prescription drugs, Frisch said. The drugs are often kept under lock and key and require a tighter control of inventory.
Only patients or a patient designee with a valid prescription and identification are allowed to pick up prescriptions, Frisch said.
Dr. George Kaiser, program director of the Internal Medicine Department at the University of Nevada School of Medicine, would not comment directly on the lawsuit, but said the drugs Gabriel is accused of prescribing are highly addictive.
Although the drugs are narcotics that are prescribed to treat chronic or acute pain, it is easy for patients to build up a tolerance to the drugs. That is particularly true with Oxycontin, he said.
"It is possible to get out of control," he said. "They are rapidly addicting drugs."
The frequency with which doctors prescribe the pain pills has become increasingly controversial in recent years, Kaiser said.
While doctors were once instructed to prescribe drugs such as Oxycontin conservatively because of their addictive nature, the drugs are very successful at treating patients' pain.
"The pendulum has swung in both directions," he said. "It's a fairly controversial area. Because Oxycontin has a more addictive profile, it's under more scrutiny."
According to the suit, Gabriel, a pediatrics and preventive medicine specialist at Low Cost Medical Clinic, 5000 West Oakey Blvd., treated Woody for chronic back pain from Nov. 9, 2002 to April 17, 2003.
During that time, the suit alleges, Gabriel "intentionally provided opiate narcotics to plaintiff with such a callous indifference to value of human life, as to create, develop and foster a powerful opiate addiction."
Saggese claims Woody became addicted to the pills and suffered pain, organ damage and mental and emotional stress as a result. The suit seeks damages in excess of $10,000.
Saggese said Woody had battled a previous addiction to painkillers and had bouts with other narcotics prior to that. He said his client hit rock bottom, however, when he began seeing Gabriel.
Other patients who have come forward were not addicted to painkillers before they began seeing Gabriel, Saggese said. Either way, Gabriel is still responsible, he said.
"It's like saying a drug dealer is not responsible for selling drugs," he said. "(Gabriel) is responsible because she's supplying it."
Saggese said while Woody was "no angel," Gabriel was responsible for the his treatment.
"Addiction is a disease," he said. "You don't take a person with an addiction and give them more of an addiction."
During his treatment, Woody was taking more than 100 pills each day and getting about three to four prescriptions each week, Saggese said. The pills were a "mixed cocktail of drugs," but primarily Lortabs, he said.
In addition to the pills he obtained directly from Gabriel's office, Woody would get additional prescriptions filled at different pharmacies throughout the Las Vegas Valley, Saggese said.
Of the 100 empty prescription bottles Woody kept, about 70 of them came directly from Gabriel's office, Saggese said.
The addiction caused a downward spiral, in which Woody's wife left him and he lost his job and his condominium.
"He's completely nonfunctional. He can't even carry on the basic functions of everyday living," Saggese said.
Saggese alleges in the suit that Gabriel examined Woody during his first office visit, but that the doctor never conducted another examination throughout the treatment.
"It was reasonably foreseeable to the defendant that prescribing and dispensing over 9,000 narcotics to one man ... could lead to addiction, liver failure, blood toxicity or death," the suit states.
Kaiser said the drugs, which are in the same family as morphine, relieve pain by stimulating pain receptors in the body. The drugs are generally used to treat people who suffer with broken bones or terminal illnesses, such as cancer.
If the drugs are taken on a regular basis, however, the pain receptors can become less sensitive to the narcotic. Eventually, it takes more of the narcotic to cause an affect.
People who abuse the drugs describe the sensation they get as euphoric, Kaiser said.
"Most people describe the feeling as a glow," he said. "They are kind of sleepy. It gives you a drowsy, twilight, euphoric feeling."
Kaiser warned that patients who are prescribed narcotics for pain management should be careful that they do not develop an addiction.
If a patient begins taking the medication for purposes other than it was intended for, the patient may be developing an addiction, he said.
"If there is a loss of control, you may be crossing the line into addiction," he said.